Assessment and Management of the Seriously Ill Patient Following Abortion

ABSTRACT

In patients suffering from the consequences of a nonmedical abortion, generalization as to management has distinct limitations. Patients demand an hour-by-hour evaluation during the acute phase of the illness. No method of illegal abortion is more hazardous than injection of a substance into the uterus. Local damage may be extensive, and vascular and renal disturbances are prominent features. If instrumentation was used, infection is the problem and a favorable response usually follows removal of the infected conceptus. When hypotension persists, hysterectomy should be considered. When local abortifacients have been used, exploratory laparotomy should be considered to determine the status of the reproductive system. If there is marked tissue infarction and necrosis, hysterectomy should be performed. If there is one common denominator on which to base a judgment, it appears to reside in the kidney, which presumably reflects the status of tissue perfusion.

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